Neuromyelitis optica spectrum disorder: a case Report from Rehman Medical institute, Peshawar.

Devic\u27s disease or Neuromyelitis Optica is a serious, rare idiopathic neurological disorder which affects the optic nerve and the spinal cord. A 15-year-old girl was admitted in the neurology was with a previous history of 4 episodes of weakness in both the lower limbs and urinary retention. The patient gradually lost her eyesight in both eyes at the age of 8. Initially, she was diagnosed as a case of Multiple Sclerosis at the age of 11 when she presented with first episode of lower limb weakness. Later, Seropositivity for Aquaporin 4 IgG and clear MRI scan of the brain confirmed the diagnosis of Neuromyelitis Optica

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

RENAL ARTERY ANEURYSM – A CASE REPORT FROM KP: Renal Artery Aneurysm – A Case Report From KP

Renal artery aneurysm (RAA) is a rare lesion and occurs in less than 1% of the population. There are multiple available treatment options which depend on the type of aneurysm and the timely diagnoses of the condition. Understanding these options is important; endovascular techniques, renal auto-transplantation and nephrectomy maybe indicated.  A case of RAA in the left renal artery which was surgically treated with radical nephrectomy because of the nature of the presentation which was an emergency and was managed swiftly to save the patient’s life